Stefani Camilla, Pecoraro Luca, Flodmark Carl-Erik, Zaffanello Marco, Piacentini Giorgio, Pietrobelli Angelo
Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126 Verona, Italy.
Childhood Obesity Unit, Skåne University Hospital, 21550 Malmö, Sweden.
Biomedicines. 2023 Jul 22;11(7):2061. doi: 10.3390/biomedicines11072061.
Several epidemiological studies have described childhood obesity as a risk factor for atopic disease, particularly asthma. At the same time, this association seems to be more conflicting for allergic rhinitis, atopic dermatitis, and chronic urticaria. This article aims to deepen the possibility of a relationship between childhood obesity and allergic diseases. As regards asthma, the mechanical and inflammatory effects of obesity can lead to its development. In addition, excess adiposity is associated with increased production of inflammatory cytokines and adipokines, leading to low-grade systemic inflammation and an increased risk of asthma exacerbations. Allergic rhinitis, atopic dermatitis, food allergies, and chronic urticaria also seem to be related to this state of chronic low-grade systemic inflammation typical of obese children. Vitamin D deficiency appears to play a role in allergic rhinitis, while dyslipidemia and skin barrier defects could explain the link between obesity and atopic dermatitis. Starting from this evidence, it becomes of fundamental importance to act on body weight control to achieve general and allergic health, disentangling the detrimental link between obesity allergic diseases and childhood obesity. Further studies on the association between adiposity and atopy are needed, confirming the biologically active role of fat tissue in the development of allergic diseases and exploring the possibility of new therapeutic strategies.
多项流行病学研究已将儿童肥胖描述为特应性疾病（尤其是哮喘）的一个风险因素。与此同时，这种关联在过敏性鼻炎、特应性皮炎和慢性荨麻疹方面似乎更具争议性。本文旨在深入探讨儿童肥胖与过敏性疾病之间存在关联的可能性。至于哮喘，肥胖的机械性和炎症性作用可导致其发生。此外，过多的脂肪与炎症细胞因子和脂肪因子的产生增加有关，导致低度全身性炎症以及哮喘加重风险增加。过敏性鼻炎、特应性皮炎、食物过敏和慢性荨麻疹似乎也与肥胖儿童典型的这种慢性低度全身性炎症状态有关。维生素D缺乏似乎在过敏性鼻炎中起作用，而血脂异常和皮肤屏障缺陷可以解释肥胖与特应性皮炎之间的联系。基于这一证据，控制体重对于实现整体健康和过敏性健康至关重要，以解开肥胖、过敏性疾病和儿童肥胖之间的有害联系。需要进一步研究肥胖与特应性之间的关联，确认脂肪组织在过敏性疾病发展中的生物活性作用，并探索新治疗策略的可能性。
